The Ward Rounds Stitch-up

By Lorin McIntosh 

Still jet-lagged from my summer trip, I woke up at 7:30, instead of 6:30am. After a frantic morning routine, I make it to the hospital with ten minutes to spare. I have left my phone at home, had no breakfast or coffee, but I am determined to make it the best day.

 

As I walked through the white washed halls, a feeling of fear mixed with excitement sweeps through my veins. It is my first day of medical internship. I have been placed at Eastern Health, my top choice from my clinical years, and am beyond stoked to start my first day as a real doctor. After I arrive at my ward, I introduce myself to the team and begin to print off the lists. Just as I am finished stapling the lists (perfectly in the top left hand corner as my consultant has requested), another intern arrives. I do not remember seeing a fellow intern on the roster, but I am beyond excited when I realise that it is one of my medical school friends. We begin the ward round, just as the third-year medical students arrive.

 

Patient 1: Abdominal pain

As we begin to see the first patient, my consultant decides to ask me the anatomical landmark of the duodenojejunal junction. In a moment of fear and sheer panic, I do not remember my preclinical anatomical landmarks, and take a guess. The third year medical student then answers “the ligament of Treitz”. He then asks me to perform the DRE on the ward round, a sinister form of punishment for my incorrect answer.

 

Patient 2: Chest pain

As I am still trying to finish my note from the previous patient, we then see a patient presenting with central chest pain, radiating to the jaw and right shoulder, lasting for 20 minutes. The other intern orders troponins and I begin the process to take blood. As I am about to take the bloods, a clinical nurse educator walks into the doorway with a clipboard. I take the literal best bloods of my life and am beyond proud of my venepuncture win. The lady with the clipboard then announces that she is doing a hand wash audit for the hospital, and I have forgotten to wash my hands before putting on my blue nitrile gloves.

 

Patient 3: New onset neurological symptoms

My consultant is busy teaching the third year medical students about STEMIs versus NSTEMIs, and I decide to drag my computer to the next patient. As I am setting up outside the patient room. I notice that the patient looks a bit unwell. She has the classic facial droop and just appears a bit drowsy. I decide to go in and examine her, as my consultant is immersed in his tutorial. I note that she has a left sided facial droop, left sided arm weakness, and slurred speech. I run to my consultant and inform him that we need to call a “Code Stroke”. We call the code; the stroke team comes; there are literally like 20 people in this woman’s room. That is when the neurology registrar recognises the patient. I failed to check her medical history to see that she had suffered a stroke several weeks ago. Her current neurological issues reside around carpal tunnel syndrome in her right hand.

 

We see 12 more patients, and the rest goes fairly smoothly. In an attempt to redeem my atrocious ward round, I decide to attempt the Allied Health handover. My handover goes absolutely amazing, and I am beside myself. My consultant takes the team to coffee, and we celebrate our first day as a team.

 

After a glorious coffee, I spot one of my old registrars from when I was a fifth year medical student. We chat, and I tell him about all of the mistakes I made on the ward round. He laughs and we reminisce on his days as an intern, and he tells me that he knows an intern who had a worse day. He then tells me that his floor had an intern that did not even show up on her first day. I laugh and make a joke about how my floor had two interns. As he leaves, I internally panic and bee-line it back to the ward to check the roster. That is when I realise that I went to ward 7.2, not ward 7.1. It was me. I was the intern that did not show up on my first day.

 

Disclaimer: This is piece of creative writing and does not reflect the author’s beliefs about their own experience.  

The First Sip of Coffee

As I sit in this coffee shop beginning to write my article, the world continues to rush around me. Exhausted students with deep bags under their eyes thrust their keep cup over the counter as they order a triple shot. Businesspeople in elegant suits plaster a smile onto their faces as they sit down for their third meeting of the day. The waitress, who is already two hours into her shift, tries to ignore the pounding at her head as she glances back at the clock.

Week 9 has hit, and with it a tsunami of exhaustion.

In the past few weeks I have noticed that every time I ask someone how they are going I get roughly the same answers. Busy, tired and ready for a break. Everyone I talk to is grasping on by a thread for the break so that they can finally have a bit of rest. Maybe we will actually catch up on sleep. Maybe we will catch up with friends. Maybe, just maybe we will even catch up on the lectures. I don’t know about you, but I always feel like I am falling into the trap of looking forward. Dreaming so much of the mid sem break that I want week 9 to pass in the blink of an eye. Dreaming so much of the summer break that I want the rest of semester to just shoot past. And then, when it is over, I look back and wonder how it passed so quickly. Disappointed that my first year is over and I will never be able to get it back.

Why didn’t I appreciate it while it was there? When I hit the snooze button 3 times and crawled out of bed, did I appreciate that I woke up this morning? Did I appreciate that I was able to get out of bed on my own without the help of a nurse or walking frame? Did I appreciate that I had family or friends that I could contact at the click of a button? Probably not. I was likely so distracted by how tired I was that I forgot to acknowledge these things. Taking for granted what others would consider a luxury.

Is it the same for you? Do you ever find yourself wishing time away? Not really appreciating the days you have and the experiences that you are going through? I’m sure we all do it sometimes, especially as the semester comes to a close. So distracted by the hustle that we forget to just be present and enjoy it.

What can you do today that will help make you more present and appreciative of what is happening?

For me this can look like a few things:

  • Praying
  • Thinking about what I am grateful for
  • Turning my phone off
  • Keeping a journal
  • Making a cooked breakfast
  • Reading my bible
  • Going for a run or a walk without my phone
  • Mediation
  • Yoga
  • Study or read in a coffee shop
  • Taking the time to really appreciate my cup of coffee in silence

This list is definitely not extensive, but it is a start. A lot of the time they can even be paired. I have noticed that thinking about what I am grateful for can have the biggest impact and so while I have that cup of coffee, I thank God for specific things. How the lecture last week made more sense than usual. How my little sister calls me when she needs some advice. How my friend trusted me enough to confide in me.

Writing my journal is very similar, it just helps to get it on paper. To cement it a bit more, and to give me something to read back on when everything is falling apart. In fact, all of them are probably quite similar. They are just about stopping, being present, being grateful. It just takes 10 minutes but it makes a huge difference throughout the day.

The challenge I set myself is to make this a habit. To take 10 minutes every morning, every day to just enjoy that first sip of coffee.

Will you join me?

 

The Arena

By Michelle Xin 

Over 150,000 faces join me each day – yet another member of the infinite audience spectating the arena; my arena.

I watch and I wait, for I am always surprised by those who enter my realm, and I will never know who might be next.

There have been moments in time where I have speculated and predicted. Even moments where I have hedged my bets, because it was clear that this next individual inflicted with the plague will soon succumb, as did their predecessors. When they arrive here, they are lost and aghast. They fight and they rebel, for this was not the outcome that they deserved, nor the fate which their beliefs promised. They ask me for more years, for more cures to the maladies of their time, for another chance in another world. Their presence in the audience is begrudging and initially disruptive, but they take their seats eventually when time wears away at their mortal fire within.

However, in the recent years, I have hesitated to extend my foresight into the living as the care in which the mortals have now devised add sand to their depleting hourglasses. Their medicines and machines have stretched the boundaries of time and have challenged nature’s course and equilibrium. There have been many who I have expected sooner, and yet they continue to occupy their thrones of dialysis chairs with defiance and calm etched into their faces. There are endings which I have not yet witnessed because instead, I have witnessed the life jackets of tablets and transfusions and operations assisting individuals to remain afloat.

In centuries past, I longed for the stories of mortals; their earnest spontaneity inspired me, their unbridled suffering intrigued me, and each youthful emergence into my arena invigorated me – for their arrival in my arena allowed me to hear of their tales and their memories, both freshly made and freshly severed. When the floods of individuals crowded my realm during the eras of living brutality, I sought out the faces with age written on them and found too few. Their stories were bloodied, undeserved and chilling. I could not wish for those vivid recollections, despite how heartless the mortals may perceive me to be.

Even today, there are those with many projected years who have their hourglasses tragically and prematurely broken. Their faces should not be in the audience, although the mortal world is fickle and chaotic, and chaos brews unpredictability and sorrow in its darkest moments.

Now instead, I wish for time. For more sand to be poured into their hourglasses. For their living reality to last, because only time will prepare them for the finite.

There are fewer individuals who are lost and aghast when they arrive here. Instead, I am the one who is lost in the gratitude and peace I am confronted by. The mortals’ medicines and machines have taught them what I have seen but have yet to experience – that life is a fragile creature, but nonetheless worth nurturing and treasuring. That there is strength in belief, in humanity, in the comforting reassurance of words and arms. That encountering the end can be hopeful and uplifting, as all that has preceded it is a chance worth taking and living for.

The only request that I dare to issue is for these medicines and machines to persist and to evolve and to expand, in order to afford as many individuals with this chance to live before they discover my arena. Even though these medicines and machines are fighting me, I am sorry that I must win in the end. Know that the victories gained when the extra grains of sand find their way back into mortals’ hourglasses is worth the fight, the celebration and the memory, even if it fades into the mind’s recesses one day soon.

 

It is your victory to possess the treasured time of mortality. It is my loss that I, Death, must take that away.